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Does early excision of burn wounds change the pattern of mortality?
1University of Washington Burn Center, Seattle, Washington.
Abstract:
Ninety-five patients died at the University of Washington Burn Center from 1980 to 1985. Fifty-seven patients (60%) survived more than 3 days. Thirty-five of these patients underwent excision and grafting. The major causes of death were pneumonia, burn wound sepsis, and sepsis from multiple sources. Thus infection was the cause of death in 26 (74%) of these 35 patients. The other 22 patients who survived longer than 3 days did not undergo excision and grafting before death. The primary cause of death was pneumonia. Infection was the cause of death in 12 patients of this group (55%) and thus was the major cause of death in 62% of all patients who survived more than 3 days. Although early wound closure may affect overall mortality, it does not appear to materially change the pattern of the causes of death in those that die after 3 days of hospitalization.
Insights
Infection remains a primary cause of death for burn patients surviving over three days, even with early wound closure interventions. This study highlights infection
Area of Science:
- Medical Research
- Infectious Diseases
- Burn Care
Background:
- Infection is a significant cause of mortality in burn patients.
- Understanding the specific causes of death is crucial for improving patient outcomes.
Purpose of the Study:
- To analyze the causes of death in burn patients at the University of Washington Burn Center from 1980 to 1985.
- To determine the impact of early wound closure (excision and grafting) on mortality patterns.
Main Methods:
- Retrospective analysis of 95 patient deaths between 1980 and 1985.
- Categorization of deaths based on survival duration (>3 days) and treatment (excision and grafting).
- Identification of primary causes of death, with a focus on infection.
Main Results:
- Infection was the cause of death in 74% of patients who underwent excision and grafting and survived >3 days.
- Pneumonia was the primary cause of death in patients who survived >3 days but did not undergo excision and grafting.
- Overall, infection was the major cause of death in 62% of patients surviving >3 days.
Conclusions:
- Infection remains a leading cause of death in burn patients who survive the initial critical period.
- Early wound closure does not appear to significantly alter the pattern of causes of death in patients who die after 3 days of hospitalization.
- Further strategies to combat infection are essential for improving survival rates in severe burn cases.